• Int J Obstet Anesth · May 2018

    Impact of epidural analgesia on cesarean and operative vaginal delivery rates classified by the Ten Groups Classification System.

    • M Lucovnik, I Blajic, I Verdenik, T Mirkovic, and T Stopar Pintaric.
    • Department of Perinatology, Division of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Slajmerjeva 4, 1000 Ljubljana, Slovenia. Electronic address: miha.lucovnik@kclj.si.
    • Int J Obstet Anesth. 2018 May 1; 34: 37-41.

    BackgroundThe Ten Group Classification System (TGCS) allows critical analysis according to the obstetric characteristics of women in labor: singleton or multiple pregnancy, nulliparous, multiparous, or multiparous with a previous cesarean delivery, cephalic, breech presentation or other malpresentation, spontaneous or induced labor, and term or preterm births. Labor outcomes associated with epidural analgesia may be different among the different labor classification groups. The aim of this study was to explore associations between epidural analgesia and cesarean delivery, and epidural analgesia and assisted vaginal delivery, in women classified using the TGCS.MethodsSlovenian National Perinatal Information System data for the period 2007-2014 were analyzed. All women after spontaneous onset or induction of labor were classified according to the TGCS, within which cesarean and vaginal assisted delivery rates were investigated (P <0.003 significant).ResultsData on 207 525 deliveries (and 211 197 neonates) were analyzed. In most TGCS groups women with epidural analgesia had lower cesarean delivery rates. Women in group 1 (nulliparous term women with singleton fetuses in cephalic presentation in spontaneous labor) with epidural analgesia had a higher cesarean delivery rate. In most TGCS groups women with epidural analgesia had higher assisted vaginal delivery rates.ConclusionEpidural analgesia is associated with different effects on cesarean delivery and assisted vaginal delivery rates in different TGCS groups.Copyright © 2018. Published by Elsevier Ltd.

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